2001-10-29_REPORT - M1978271

• Permit No: M1978271
• IBM Index Class Name: Report
• Doc Date: 10/29/2001
• Doc Name: Annual Fee/Report/Map
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

. III IIIIIIIIIIIII III
999
ANNUAL FEE and REPORT REQUEST
PERMITTEE NAME: Asphalt Gravel Products, Inc. RECEIVED
PERMIT NO.: M-1978-271
OPERATION NAME: Garrett Pit OCT 2 9 2001
ANNIVERSARY DATE: October 30,2001 Division of Minerals and Geology
ANNUAL FEE DUE: $688.00(Due on or before your anniversary date)
COUNTY: Conejos
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116,each year, on the anniversary date of the permit, an operator
shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
reclamation accomplished to date and during the preceding year, new disturbances that are anticipated to occur
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements nzay suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact: Rock I. Southway
Permittee Name: Asphalt Gravel Products, Inc.
Address: 117 White Pine Dr.
Alamosa, CO 81 101
Phone Number: [phone]
Fax Number: [phone]
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
=: +�
Signature of Corporate Officer 9 Owner
10-24-01
Date
A1:\PERMITW ASTERDOCUMENTS\M-AF-01